Changes in public expectations of the American health system have led to new demands on graduate medical education programs. To gain accreditation, these programs must now teach a set of competencies related to practicing effectively in today's complex environment. Further, they must assess and document the educational outcomes of the competency training. The assumption underlying these mandates is that improved educational outcomes will translate into improved health and system outcomes. Yet to date, virtually no research has examined this link. Building this evidence base is critical to establishing the importance of the new competencies and to further enhancing the curriculum. Tufts Health Care Institute (THCI) seeks an Agency for Healthcare Research and Quality (AHRQ) small conference grant to address this research gap. The grant will support one half-day session of THCI's conference, "Competency Assessment: Forethought not Afterthought" to be held in Boston, September 10-12, 2003. The session, "Research Initiatives and Opportunities," will review existing initiatives and explore opportunities for future research examining links between training in the new competencies and health outcomes. The conference is expected to draw 200 residency program directors and institutional leaders from around the country. THCI is a recognized leader in professional development for this audience. It has organized two prior national conferences on the new competencies, each of which filled to capacity. While the past conferences focused on understanding and incorporating the content of the competencies, this one will address assessment, documentation, and research. The first of three half-day sessions will cover integrating assessment into curriculum development; the second will focus on applying assessment tools to measure and document competence; and the third will address opportunities for research linking competency training with system improvement and health outcomes. An AHRQ grant will not only support the research session but also enable THCI to disseminate conference summaries and proceedings to health care leaders nationwide who have a stake in these issues